Peripherally Inserted Central Catheters And Midline Catheters

GENERAL INFORMATION:

• Peripherally inserted central catheters (kath-uh-ters) (PICC) and midline catheters are used when you need IV medicines and fluids. A catheter is a small flexible plastic tube. The catheter is put in through a vein under your skin. A vein is a tube inside you that carries blood from the body to the heart. The catheter is usually put into a vein on the inside of your arm. Then it is tunneled up towards and sometimes past your shoulder.
  
  
• A midline catheter is put into a vein by the bend in your elbow, and ends in a vein before your shoulder. A PICC line is put in the same place, but it ends in the vein by your heart. Through a PICC or midline catheter, you may have blood taken for tests. You may also get IV fluids and medicines quickly and easily. Having the catheter may keep your arm from being stuck many times with a needle. The catheter will have 1 or 2 small tails (tubes) coming from your arm where the catheter was put in.

Why do I need a PICC line or midline catheter?

• PICC lines and midlines are used for long term treatments. Midlines may be used for up to 4 weeks. PICC lines may be used for up to a year. They are often put in to give yourself medicines at home. You may need a PICC or midline catheter because caregivers cannot use smaller veins in your body. Smaller veins may be damaged, or they may have poor blood flow.
  
  
• Catheters are also used in case of emergency when you would need medicines or fluids very quickly. PICC lines can usually stay in much longer than midlines. Because of this, some treatments and medicines given through PICC lines are different from ones given through midlines.
  
  
• The following are medicines and treatments you may get when you have a midline catheter. With a PICC line you may also get blood and chemotherapy (kee-mo-ther-a-pee). Chemotherapy is medicine for cancer.
  
  
  • Antibiotics. These are medicines to prevent infection (in-feck-shun).
    
    
  • Frequent blood sample collection.
    
    
  • IV medicines that would make your smaller veins sore or damaged.
    
    
  • Receiving IV fluids for a long period of time.
    
    
  • Pain medicine.
    
    
  • Total Parenteral Nutrition: This is also called TPN. TPN is a special liquid food that goes directly into your veins.

What will it be like when I get my PICC line or midline catheter inserted?

• You will be asked to lie on your back. Your caregiver will decide which arm is best to use for the catheter. Tell your caregiver if you are right-handed or left-handed. Your sleeve may be rolled up to show your arm or you may have to take your shirt off. Your arm will be measured so that caregivers know how far to put the catheter in. You may need hair clipped on your arm where your catheter will be put in. Your caregiver will clean this area with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Towels will be put over you to keep the area clean. Do not touch the towels or the area that has been cleaned.
  
  
• A special x-ray called a venography (veen-o-graf-e) may be done. For this test, dye is put into your vein to make it easier for caregivers to see. Your caregiver will put a needle with a plastic cover through your skin into your vein. The needle will be removed and the cover will be left in to hold the vein open. The catheter will be put through the plastic cover into the vein. PICC lines have a small wire in them to help with putting them into the vein. Midline catheters do not have a wire in them. The catheter will be tunneled through your vein and up your arm. X-rays may be used to see that the catheter has gone into the right place. When the catheter is in the right place, the plastic cover and the wire will be removed.
  
  
• Tell your caregivers if have strange feelings in your hand, arm, shoulder, chest, neck or ear. Your caregiver can move the catheter to make this stop. When the catheter is in the right place, your caregiver will tape the catheter end to your skin and put a clean bandage over it. There may be one or two tubes (tails) hanging out from where the catheter was put in.

How and when is the PICC line or midline catheter removed?

• Your caregiver will remove the catheter for you. You may go to a hospital or an Infusion Center to have this done. It may also be done by a caregiver at your home.
  
  
• The bandage will be removed and any stitches holding the catheter in place will be removed. The catheter is gently pulled out of your arm. Pressure is held over the place where the catheter was removed. The catheter is measured to make sure all of it came out. A new bandage will be put over the area where the catheter was removed. You may need to have another catheter put in. Your PICC or midline may be removed when:
  
  
  • A different type of catheter is needed.
    
    
  • It is time for a new catheter.
    
    
  • The catheter is causing an infection. (in-fek-shun).
    
    
  • You no longer need the IV medicine or treatments.
    
    
  • Your catheter is blocked or no longer works right.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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